# AWAKENING BEHAVIORAL HEALTH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** AWAKENING BEHAVIORAL HEALTH, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1962947101
- **Legal business name:** AWAKENING BEHAVIORAL HEALTH, LLC
- **Authorized official:** KERRYLYNN BACA-PELPHREY (CCO, EXEC DIR PAYOR RELATIONS)
- **Authorized official phone:** (801) 658-9646

## Contact information

- **Practice address:** 9160 S 300 W STE 3, SANDY, UT 84070-2656
- **Practice address phone:** (801) 545-0406
- **Mailing address:** 2973 W 13800 S, BLUFFDALE, UT 84065

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0850X | Adult Mental Health Clinic/Center | 37088 | UT | — |
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center | 37087 | UT | — |
| 261QR0800X | Recovery Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/26/2016
- **Last updated:** 11/27/2023